Today’s post was written by Edward J. SanFilippo, Economic Development Policy Fellow for the Alliance.

Mention post-traumatic stress disorder (PTSD) as it relates to homelessness, and most people will probably think of military veterans, but other homeless populations struggle with PTSD. Indeed, the experience of homelessness itself is a trauma that can lead to PTSD.

PTSD is an anxiety disorder that can occur after an individual has experienced a traumatic event, particularly one that involves the threat of injury or death. It is still unclear why a particular trauma may lead to PTSD for some individuals but not for others, or why some individuals are traumatized by a particular event when others are not.

We do know that:

PTSD changes the body’s response to stress;

An individual with a history of trauma may be more susceptible to experiencing PTSD from a future traumatic event; and

Symptoms of PTSD may not appear for weeks or even months after the triggering traumatic event.

The actual event of becoming homeless can lead to trauma through the loss of stable shelter, family connections, and accustomed social roles and routines;

The ongoing condition of homelessness creates stressors that include the uncertainty of where to find food and safe shelter and the potential for experiencing violence and victimization, which can erode a person’s coping mechanisms; and

Homelessness might serve as a breaking point for those who have preexisting behavioral health conditions or a history of traumatization.

“Reliving” the event, which disturbs day-to-day activity, including, for example, flashbacks and nightmares;

Avoidance, which includes emotional numbing and feeling detached; and

Arousal, which might include difficulty concentrating, sleep disturbances, and outbursts of anger, amongst other symptoms.

One of the greatest challenges for homeless service providers is that the PTSD is post-traumatic, not co-occurring-traumatic. Its symptoms may not manifest until after a person is stably housed. Another challenge for providers comes from the fact that delaying the housing component can create more psychological barriers to housing stability.

Fortunately, research shows that post-trauma resiliency can be learned through effective training programs for both consumers and providers.

At a minimum, homeless assistance providers should ensure that programs and policies reflect the needs of people suffering from PTSD:

Housing should be provided as quickly as possible to provide safety and stability while minimizing the potential for associated traumatic experiences;

Since symptoms may be delayed, people receiving homeless assistance should be counseled about psychological changes they may experience in the future, and offered referrals for psychiatric help; and

People suffering from PTSD need ongoing support to reach a successful recovery and reintegration into social routines.

In August 1012 I tried to find any homeless advocate that could help me explain to a judge what being left homeless for over 5 yrs by a convicted felon does to a human being. Then I turned to the Occupy groups who have covered the homeless issue.

No advocates could be found.

When I entered the courtroom the criminal defense attorney started mocking me. He very flamboyantly looked around the courtroom laughing, “Where are ALL of these homeless advocates and Occupy members?”

I didn’t know if I was going to start crying.. or get angry enough to make my voice heard. The District Attorney refused to let me speak to the judge – so I had traveled over 3 states, had been traveling since 3am in the morning, JUST to be mocked by a criminal defense attorney. Nothing more, nothing less.

It was the end of me, emotionally and physically. I could not believe that this was the final insult in an almost 5 year battle to get my home back.

I walked away knowing that I was no longer a human being. No longer irreplaceable. No longer worthy. I had become an invisible statistic – a joke. Perhaps I had been that all along.

Emily Wischhusen

22/10/2012

Denise, I am sorry to hear about what you’re experiencing. I do not know what City you’re in, what legal needs you are facing, and what services or resources may be available to you where you are…I do know that legal issues and experiencing homelessness are not measures of a persons value or worth. You sound like an insightful, intelligent person, who has had to practice a great deal of courage in the last 5 years. Focus on those qualities. You are not joke. You are a human being. You are worthy and irreplaceable. A District Attorney does not have the power to make you feel or know any different unless you let him.